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> If I were a billionaire there is no way in hell I'd wait for a standard drug trial to progress on an FDA timeline.

You don't have to be a billionaire for this. There aren't many drugs which sit between proving efficacy in clinical trials and FDA approval, and ones that are like that only sit there for a few months. Of course, those could be important months for a particular patient, but there are ways to handle this. One such program is called "compassionate use". The idea is that if you have no other hope, you can be prescribed a non-approved treatment.

There aren't as many potholes in this as you seem to believe. Drugs which are proven efficacious and safe usually are submitted for approval, because it's expensive to run trials. It wouldn't be the first time a billionaire decided to do something medically unwarranted or ambiguous, but that doesn't mean it will become a norm.



Your comment made me realized I forgot an important predicate.

I think we're near an explosion of drug targets. That the front-end of the pipeline is about to get very full very fast.

That's one of the forcing factors I didn't mention.




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